| NPI | 1184725921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: WI 41191) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 41191) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: ND 1105) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: ND 11005) | |
| 208600000X Surgery (Licence: ND 11005) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2008-09-24 |